Zeldis J B, Dienstag J L, Gale R P
Am J Med. 1983 Jan;74(1):64-8. doi: 10.1016/0002-9343(83)91119-1.
Severe aplastic anemia is a rare but important complication of hepatitis. The agent(s) responsible for the hepatitis in these cases have not been well defined. Sixteen patient with hepatitis-associated aplastic anemia were studied for evidence of recent infection with hepatitis A virus, hepatitis B virus, cytomegalovirus, Epstein-Barr virus, and Toxoplasma. Results were compared with data from 10 randomly selected patients with aplastic anemia unassociated with hepatitis. Of the 16 patients, recent acute hepatitis A infection could be excluded in at least 14 patients. Hepatitis B surface antigen (HBsAg) was present in only one patient. A diagnosis of recent hepatitis B infection could not be excluded with confidence in two others. Tests for cytomegalovirus, Epstein-Barr virus, and Toxoplasma gave negative results. No patient with aplasia unassociated with hepatitis had evidence of recent hepatitis A infection, and the frequency of hepatitis B antibodies in this group was indistinguishable from that in patients with hepatitis. These data indicate that most cases of hepatitis that preceded aplastic anemia were not caused by hepatitis A virus or hepatitis B virus; non-A, non-B agents were probably involved in at least 13 of the 16 cases studied.
重型再生障碍性贫血是肝炎的一种罕见但重要的并发症。这些病例中导致肝炎的病原体尚未明确界定。对16例肝炎相关性再生障碍性贫血患者进行研究，以寻找近期感染甲型肝炎病毒、乙型肝炎病毒、巨细胞病毒、爱泼斯坦-巴尔病毒和弓形虫的证据。将结果与10例随机选取的非肝炎相关性再生障碍性贫血患者的数据进行比较。16例患者中，至少14例可排除近期急性甲型肝炎感染。仅1例患者存在乙型肝炎表面抗原（HBsAg）。另外2例无法确切排除近期乙型肝炎感染的诊断。巨细胞病毒、爱泼斯坦-巴尔病毒和弓形虫检测结果均为阴性。非肝炎相关性再生障碍性贫血患者中无近期甲型肝炎感染证据，该组乙型肝炎抗体频率与肝炎患者组无差异。这些数据表明，再生障碍性贫血之前的大多数肝炎病例并非由甲型肝炎病毒或乙型肝炎病毒引起；在所研究的16例病例中，至少13例可能涉及非甲非乙型病原体。
